Medicare Part D

Did you know that if you have Medicare, any prescription medications not administered in an inpatient setting (which would be covered under your Part B plan) are not covered under traditional Medicare? To obtain coverage, individuals must purchase a “Part D” plan to obtain outpatient prescription-drug coverage.

Not every policy is created equal. Part D supplemental insurance plans will vary in terms of the monthly premium costs, as well as the drugs that are covered under the drug formulary.
(Please note: for anyone who is not familiar with the insurance terms used in this section, please see our Healthcare Insurance Glossary)

Questions to ask when selecting a Part D plan:

Can I afford the monthly premium for this plan?

Which MS medications are on this plan’s drug formulary?

If my current medication is covered, what other options are available if I need to switch?

What will the co-pay be for my MS and symptom-management medications, and can I afford this in addition to the premium?

The best place to compare Part D plans is on the Medicare website under the section, Drug Coverage (Part D), Medicare Plan Finder. Here you will find an online tool where you can enter in your location and the names of the medications you are taking. This will allow you to see which plans are offered in your area and also cover your medications. It will allow you to directly compare plans against each other – both in terms of cost (of the monthly premiums) and coverage (if they cover your specific medications).

Please note that if the cost of a supplemental plan is too high, you may be eligible for Extra Help. This is a Low Income Subsidy (LIS) to help cover the cost of your monthly premiums and reduce your medication co-pays. To find out if you may qualify for the LIS program, please contact Medicare at (800) Medicare (633-4227) to discuss your financial situation.

For More Information

Visitors to MSAA’s online My Health Insurance Guide are invited to browse throughout the different sections for more information on the different parts of Medicare as well as other insurance options, or to view our Healthcare Insurance Glossary, online webinars and video, or our new publications.